Tuberculosis (TB) affects 10 million people annually and accounts for a 10% mortality rate despite available treatments. Challenges such as treatment complexity, adherence difficulties, and disease recurrence highlight the need for robust, real-world evidence to optimize therapies. The World Health Organization (WHO) proposes developing a collaborative trial platform, bringing together countries with high TB burdens to conduct large-scale, person-centred, pragmatic trials. This initiative aims to accelerate the identification, validation, and adoption of more effective treatment regimens, leveraging WHO's expertise in facilitating global collaboration and implementation.